H5N1

India after Blackout Tuesday

Via The Times of India: Powerless and clueless: 684 million Indians without power. I gather that most hospitals, inured to local blackouts, have their own emergency generators. But healthcare workers trapped in traffic aren't much use to patients. Excerpt:

It was a Terrible Tuesday that 684 million Indians are not going to forget in a hurry. In the world's biggest blackout that affected one-tenth of the global population, 21 states and Union Territories went on the blink after three arterial power lines collapsed at 1 pm. 

The northern, eastern and north-eastern regions suffered the outage when their respective grids collapsed in quick succession with devastating effect. The blackout disrupted normal life, rail and air services as well as industrial production across sectors. 

Even as the country was reeling under the outage, power minister Sushil Kumar Shinde was moved out to the home ministry, and Veerappan Moily given the additional charge of power - a move that hardly indicated seriousness on the government's part in dealing with the crisis. 

Some 300 miners were trapped in coal mines. Two hundred miners were evacuated from mines in Bengal. Efforts were still on till the time of reporting to rescue 65 others stuck in Jharkhand mines. 

More than 300 trains were affected. Many others are likely to be cancelled. Airports, hospitals and BPOs functioned with their back-up generators. In Delhi, once again commuters had a harrowing time, and a scary one for those who were stuck in the Metro Rail trains that stopped in their tracks several feet above the street or deep inside tunnels. Roads were gridlocked as traffic lights stopped working.

I have a bad feeling that this won't be the last time, or the only country, that experiences a blackout like this.

Sierra Leone: MSF battling cholera in Freetown

Via ReliefWeb, a report from MSF: Battling cholera in freetown, Sierra Leone. Excerpt:

Sierra Leone’s capital. Freetown, is currently struggling to contain a cholera outbreak that has affected over 1,500 people and killed at least 17 to date. Doctors Without Borders/Médecins Sans Frontières (MSF), in collaboration with the Ministry of Health, is already running three cholera treatment units in the city and has treated more than 500 patients. Because the number of people infected continues to grow, however, MSF plans to open two additional treatment facilities up in the next 10 days.

"We are moving quickly to increase our capacity to handle all the new patients that will arrive,” says Karen Van den Brande, MSF head of mission in Sierra Leone. “Our present cholera treatment facilities are stretched to the limit with patients. The patients that we see are of all ages, so it’s not just children or already weak people that are at risk.” 

Many of the patients come from slum settlements, where proper systems for drainage and waste disposal are almost inexistent, leaving people ever more vulnerable to the spread of water-borne diseases like cholera. 

“The living conditions in the slums are a breeding ground for disease,” says Van den Brande. “You see children playing with rubbish and bathing in polluted waste water. The central water supply system is dysfunctional and many water points are contaminated. The risk of disease spreading in such places are really high unless strict precautions are taken.” 

MSF is working with the Ministry of Health to disseminate health promotion messages about how people can protect themselves and others against the spread of disease. This includes washing hands properly, using only boiled water, and making sure that food is cooked or washed properly before consumption. Information about how and where to seek help if needed is also being communicated. 

“It is crucial that the general public is aware, that they know how to seek help immediately if experiencing symptoms,” says Van den Brande. “Without help, people can die within 20 hours. Some patients are so dehydrated that they are in coma when they arrive.”

US: H3N2v case confirmed on Maui

Thanks to the reader in Hawaii who sent the link to this report in Maui Now.com: Swine Flu Case Confirmed on Maui. Excerpt:

Local and federal officials are investigating a confirmed H3N2v flu case in an adult patient on Maui. 

State health officials have described the case as a “variant flu”.  According to the Centers For Disease Control and Prevention, investigations reveal that human infections with the virus have appeared following contact with swine as well as limited human-to-human transmission. 

The Hawaii State Department of Health is working with federal and state partners to determine the source of how the resident contracted the virus. 

State health officials say the individual sought medical attention after experiencing symptoms consistent with the regular flu, including fever, cough, and body aches. 

The patient’s primary care doctor sent a respiratory specimen to the State Laboratories Division for testing.  Authorities say the results were confirmed late last week by the CDC. 

The patient has since fully recovered, and did not require hospitalization, state health officials said. 

“Fortunately, we have a robust surveillance network and our State Laboratory detected this variant virus and conferred with federal partners,” said Health Director Loretta Fuddy in a statement. 

“Thanks to the excellent cooperation of Hawaii’s healthcare providers, participation in our sentinel network exceeds CDC recommendations. In addition to our state laboratory’s ability to identify unusual flu strains, sentinel physicians contribute to our ability to catch incidents such as this, which might otherwise fall below the radar,” said Fuddy. 

State health officials say the H3N2v virus identified in this case shares genetic similarities to variant flu viruses which have been identified in several other states in the past year. 

The virus is rare in humans, according to health officials.  Authorities say the small number of previous infections occurred mostly among children and those who work closely with pigs. 

In this case, preliminary DOH findings suggest the latter exposure, although the investigation is ongoing, health officials said.

Ebola in Uganda: A little background

Via National Geographic.com: Ebola in Uganda: Why Can't We Cure It? Where Does It Hide? Click through for the full report and several links. Excerpt:

The latest Ebola occurrence is thought to have started in Uganda's western Kibaale District about three weeks ago, but was confirmed only last Friday. 

The outbreak initially went undetected, because patients did not show typical Ebola symptoms, such as hemorrhaging, and because they had other illnesses, such as malaria, which complicated diagnosis, according to Ugandan officials. 

Among the 14 dead are a medical clinic officer and her four-month-old baby, as well as 9 members from a single family. A dozen others suspected to be infected have been admitted to the local hospital, according to the Washington Post. 

This is not the first time Ebola has struck Uganda: In 2007 an outbreak killed 42 people, and an epidemic in 2000 killed more than 200. 

The virus is still so mysterious that no one knows how it originated, in which species it hides out between epidemics, or how to treat it. There's also a lack of understanding of how Ebola is transmitted, as Uganda's president demonstrated in a national address Monday. 

"We discourage the shaking of hands, because that can cause contact through sweat which can cause problems ... and avoid promiscuity, because these sicknesses can also be transmitted through sex," Yoweri Museveni said in the address. 

But the idea that Ebola can be spread by shaking hands—via sweat—is a myth, according to Joseph Fair, vice president of Metabiota, a San Francisco-based company that studies Ebola and other pathogens. 

"Ebola is not currently known or thought to be transmitted by perspiration," Fair said. Ebola is transmitted by bodily fluids. 

Overall, "being more aware of your surroundings and mindful of your contacts is always recommended if you live in the area of an outbreak." 

Incredibly Lethal Virus 

First reported in 1976 in the Democratic Republic of the Congo, Ebola is one of the most contagious known viruses. It's also incredibly lethal, killing up to 90 percent of its victims through widespread internal—and sometimes external—bleeding. 

Initial symptoms can appear seemingly benign, and include vomiting, red eyes, stomach pains, and hiccups. (Take an infectious diseases quiz.) 

Eventually the virus causes capillaries—tiny, branching blood vessels throughout the body—to leak, Fair explained. 

"You essentially lose the junctures between your cell walls, so your capillaries are leaking. Once that happens, you lose blood pressure and you essentially die of shock ... It's an extremely uncomfortable death."

Uganda: Ebola scare strikes Kampala

Via Google News, an AFP report: Ebola scare strikes Kampala. Excerpt:

Kampala residents have been urged to avoid contact after the deadly Ebola virus hit the city but security guard Joseph Karuba's job is to frisk people and he doesn't have gloves. 

"The thing has come back -- it came first time and we beat it, then it came again and we beat it and now it is back," he said, waiting for shoppers outside one of the teeming capital's malls. 

President Yoweri Museveni on Monday confirmed that Ebola, one of the world's most virulent diseases, had reached Kampala for the first time following an outbreak in the west of the country. 

"We shall request gloves, but for now it is a very big problem because we are exposed," Karuba said. 

Officials were searching for anyone who might have come into contact with the virus, amid public warnings for people to take precautions and avoid physical contact. 

"Ebola outbreak! What you need to know," screamed a headline in the daily New Vision newspaper. 

In Kampala -- a chaotic city of around 1.5 million people with densely populated slums and bustling markets -- the message of caution appears to be getting through to the public. 

"They are telling us about it over the radio," says Boniface Ongwang, a motorcycle taxi driver. 

"You are not supposed to touch others or drink local water. In public places don't hold someone's hand, just wave at them." 

Ongwang, 28, says that for the moment he is confident that Kampala remains more or less safe, but he has told his wife to keep his baby daughter at home.

Canada: Second C. difficile outbreak declared at Hamilton General

Via CBC News: Second C. difficile outbreak declared at Hamilton General. Excerpt:

A second C. difficile outbreak has been declared at a Hamilton hospital, this time in the surgical trauma unit of Hamilton General. 

There have been four confirmed cases of C. difficile at the Hamilton Health Sciences site, three in the unit known as 6 South. On Saturday, St. Joseph's Healthcare also declared a C. difficile outbreak. Eleven patients currently are isolated with the infection. 

The 6 South unit remains open, and there are no other symptomatic patients under investigation at Hamilton General, the hospital said in a statement. 

There have been no deaths at Hamilton General of patients with C. difficile as a result of the outbreak, said Dr. Dominik Mertz, the hospital's medical director of infection control and prevention. 

The outbreak in the surgical trauma unit at Hamilton General is likely unrelated to the outbreak at St. Joseph's, Mertz said. 

"We don't see any links currently," he said. "It's not like we have an influx of patients from St. Joseph's and vice versa." 

The hospital has implemented prevention and control measures to try to prevent the spread of the disease. It is not unusual for hospitals the size of Hamilton General to have cases of C. difficile at any given time, he said. 

"When we see a cluster of cases, we become even more vigilant than usual, ramping up our cleaning procedures, hand-washing practices, and ensuring that antibiotics are used appropriately. Infection control is always our top priority."

Thailand: HFMD rate falling dramatically, BMA says

Via the Bangkok Post: HFMD rate falling dramatically, BMA says. Excerpt:

The hand, foot and mouth disease (HFMD) infection rate in Bangkok is declining, but officials are remaining vigilant, the Bangkok Metropolitan Administration (BMA) says. 

In July, the infection rate continued to decrease as the number of new HFMD cases dropped from 599 in the third week to 266 in the final week of the month, Bangkok deputy governor Malinee Sukvejvorakij said yesterday. 

She said the rate is expected to decline further next month, but officials are still monitoring the situation carefully. 

A total of 1,787 people in Bangkok contracted the disease in July, she said. 

According to the BMA, a total of 3,772 Bangkok residents fell ill with HFMD between January and July 30, with one death recorded. 

This year's HFMD outbreak rate is five times higher than the average rate over the past five years, said Dr Malinee, adding that June and July were the months when the most infections were reported.

BBC reporters: India's power failure

Via BBC News: BBC reporters: India's power failure. Excerpt:

Here in the sweltering desert of Rajasthan, people have been waiting for rain. Electricity is particularly important in the month of July when students go to classes to prepare for exams and academic competitions. They need electricity at night to get their work done. 

But this is also the season of no rain when humidity is high, the heat is sweltering and people get taken ill. Hospitals desperately need electricity and will be very worried about what the power cuts will mean. 

In Jodhpur, shopkeepers are sitting idly outside their shops unable to handle transactions. People are sheltering under the shade of trees to keep themselves cool and doors and windows have been opened as people try to cope with the intense heat. 

Pilgrims who have been making journeys to holy sites on foot have also expressed fears that there may be no light as they sleep on the roadside when night falls. The light gives them a sense of security.

Uganda: Over 200 Kibaale schools closed over Ebola

Via New Vision: Over 200 Kibaale schools closed.

Over 210 schools in Ebola-hit areas of Kibaale have been ordered to break off early for holidays. All schools in the country are expected to officially close at the end of this week.     

The district education officer, John Kyaboona, said he had ordered all schools to close immediately. “Any school that fails to comply shall be dealt with accordingly,” Kyaboona said.    

However, the district health officer, Dr. Dan Kyamanywa, said he had only advised that schools break off for holidays early as part of measures to control the spread of Ebola. 

Uganda: Government update on Ebola

A detailed report, dated July 30, is online at the Uganda Media Centre in the Office of the President. For some reason I can't excerpt it, and it's not in a very readable format, but it seems to be the most recent official statement on the Ebola outbreak and what the government is doing to deal with it.